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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Insurance Regulation and General Principles | 20% | - Insurance Concepts
|
| Topic 2: Underwriting, Marketing and Sales Practices | 15% | - Application and Underwriting Procedures
|
| Topic 3: Accident and Health Insurance | 35% | - Health Insurance Basics
|
| Topic 4: Life Insurance Products and Provisions | 30% | - Types of Life Insurance Policies
|
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NEW QUESTION # 50
If a mother and child are without life insurance, what is the MAXIMUM amount of insurance the mother can purchase on the life of her dependent 5-year-old daughter?
Answer: C
Explanation:
The correct answer is $25,000 . Under New York Insurance Law ยง 3207(b) , life insurance may be written on the life of a minor under age 14 years and 6 months by a person who has an insurable interest in that child or on whom the child depends for support. However, the amount that may be issued is limited. For a minor over age 4 years and 6 months , the maximum is $25,000 or 50% of the life insurance in force on the life of the person effecting the insurance, whichever is greater .
Here, the daughter is 5 years old , so she falls into the "over 4 years and 6 months" category. The mother and child are both described as without life insurance , so there is no insurance in force on the mother's life to create a larger 50% comparison amount. That leaves the statutory base maximum of $25,000 .
The other answers are incorrect because $10,000 is below the permitted maximum, $50,000 exceeds the statutory limit in this fact pattern, and there is definitely not "no limit" under New York law.
NEW QUESTION # 51
In health insurance policies, the reinstatement provision is
Answer: C
Explanation:
The correct answer is A. mandatory. In accident and health insurance policies, the reinstatement provision is one of the Uniform Individual Accident and Sickness Policy Provisions , which are required by law to appear in individual health insurance contracts. These provisions are designed to ensure consistency and consumer protection in policy wording. Because they are mandated by regulation, insurers must include them in individual accident and health insurance policies.
The reinstatement provision explains how a policy that has lapsed because of nonpayment of premium may be restored. Typically, reinstatement occurs when the insurer accepts a late premium payment after the grace period has expired. When reinstated, the policy again becomes active, but the provision generally states that coverage for sickness begins after a specified waiting period (often 10 days) from the date of reinstatement, while coverage for accidents is usually restored immediately .
Since the reinstatement clause is one of the required uniform policy provisions mandated for accident and health insurance policies, it is not optional or elective . Therefore, the reinstatement provision in health insurance policies is mandatory .
NEW QUESTION # 52
If the premium is not paid at the time of application, a Statement of Good Health MUST be signed by the policyowner at the time of
Answer: B
Explanation:
The correct answer is policy delivery . In life insurance underwriting and policy issuance procedures, when the initial premium is not collected at the time of the application , the policy does not immediately become effective. Because there may be a period of time between the application date and the delivery of the policy, the insurer requires confirmation that the applicant's health status has not changed during that time.
To address this, the policyowner must sign a Statement of Good Health at the time the policy is delivered.
This statement verifies that the insured's health condition remains substantially the same as it was at the time of application and that no significant illness, injury, or medical treatment has occurred since the application was submitted. The purpose is to ensure that the risk evaluated by the insurer during underwriting is still accurate before coverage becomes effective.
If the applicant had paid the first premium at the time of application and received a conditional receipt, this additional statement might not be required. However, when the premium is unpaid, the Statement of Good Health must be completed at policy delivery , making Choice C correct.
NEW QUESTION # 53
A single contract for group medical insurance issued to an employer is known as
Answer: A
Explanation:
In group medical insurance, the insurer issues one main contract to the sponsoring entity-commonly an employer-covering the eligible group of employees. This single contract is called the master policy . The employer (or group sponsor) is the policyholder of the master contract, and it contains the controlling provisions: eligibility rules, benefits, limitations, exclusions, premium requirements, renewal provisions, and administrative terms.
Employees covered under the plan do not usually receive their own individual policies. Instead, each insured employee receives a certificate of insurance (sometimes called a certificate), which summarizes the essential coverage provisions and the benefits available to that employee under the master policy. The certificate is evidence of coverage, but it is not the controlling contract; the master policy governs.
Option A ("group policy") is a generic phrase and can refer broadly to group insurance, but the specific term for the single contract issued to the employer is master policy . Option C is not a standard insurance term, and option D is incorrect because a "certificate" is issued to employees, not as the primary contract.
NEW QUESTION # 54
With respect to a life settlement contract, no person shall directly or indirectly pay a referral or finders fee to any person other than the
Answer: A
Explanation:
The correct answer is life settlement broker . Under New York Insurance Law Article 78 , the life settlement rules prohibit paying a referral or finder's fee to most persons connected with the policyowner, including the owner's physician, attorney, accountant, insurance producer, insurance consultant, or other person providing medical, legal, or financial planning services . The statute specifically states that such compensation may not be paid to any of those persons, or to any other person representing the owner, other than a life settlement broker .
This rule is designed to prevent conflicts of interest and to ensure that recommendations about life settlements are not improperly influenced by side compensation. New York permits compensation only where it is paid in connection with the role of a licensed life settlement broker , because that person is regulated under the state's life settlement framework. The broker is the recognized professional authorized to represent the owner in the transaction and receive compensation in that capacity.
NEW QUESTION # 55
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